Assertive Continuing Care for Adolescents

Abstract

Substance use disorders among adolescents, even treated adolescents, are perhaps more likely to result in relapse-remission cycles than among the adult population. Providing additional services for youth following discharge from treatment for substance use disorders is historically well-established and known as "aftercare" or more currently better understood as "continuing care" and viewed as a critical component of recovery management. In practice, continuing care is often a set of recommendations (relapse prevention plan) and referrals provided adolescents at the time of discharge. Unfortunately, research findings reveal relatively low rates of formal continuing care for adolescents who complete their index treatment episode and worse rates for those who leave treatment against staff advice or at staff request. Complicating matters further, adolescent patients are not as likely as their adult counterparts to attend 12-step or other mutual aid meetings. Assertive approaches to continuing care recognize that many, perhaps most, treated adolescents do not follow through with traditional referral recommendations, even if prescheduled appointment times are provided. Assertive approaches shift the responsibility for service linkage from the adolescent and his or her caregiver to a provider, care advocate (e.g., recovery coach), or other personnel who will assure continuity of care. This chapter provides a detailed description and findings from a face-to-face approach to assertive care, evaluates this approach against the Washington Circle performance measure for Continuity of Care, and ends with descriptions of several additional assertive approaches to continuing care that will be tested in the future. (PsycINFO Database Record (c) 2016 APA, all rights reserved)